基于赋码的外来医疗器械链式管理方案在消毒供应中心安全管理中的应用

夏春晓; 邱小丹; 倪乐丹; 冯永增; 陈果果

doi:10.16766/j.cnki.issn.1674-4152.003481

基于赋码的外来医疗器械链式管理方案在消毒供应中心安全管理中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003481

1.
温州医科大学附属第二医院消毒供应中心, 浙江温州 325027
2.
温州医科大学附属第二医院骨科

基金项目:

浙江省医药卫生科技计划项目 2020KY183

温州市科技局项目 Y2020712

详细信息

通讯作者:
夏春晓，E-mail：xiachunxiao8@163.com

中图分类号: R197.39
计量
- 文章访问数: 52
- HTML全文浏览量: 23
- PDF下载量: 0
- 被引次数: 0
出版历程
- 收稿日期: 2023-10-20
- 网络出版日期: 2024-05-29

Application of external medical device chain management scheme based on coding in safety management of Central Sterile Supply Department

1.
Central Sterile Supply Department, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China

摘要

摘要: 目的对消毒供应中心外来医疗器械实施基于赋码的链式管理模式方案，并探讨其对外来医疗器械链式管理环节质量控制检测不合格率和医护人员工作满意率的影响。方法随机抽取温州医科大学附属第二医院消毒供应中心2022年1月17日—2月6日的90个外来器械包作为对照组，随机抽取2022年6月13日—7月3日的90个外来器械包作为干预组。对照组采用传统外来医疗器械管理方式，干预组在对照组的基础上，于2022年3月1日开始在本院实施基于赋码的外来医疗器械链式管理方案，比较2组外来医疗器械链式管理环节质量控制检测不合格率和医护人员对外来医疗器械管理工作的满意率。结果干预组90个外来器械包管理环节不合格率为24.76%(156/630)，干预组90个外来器械包管理环节不合格率为7.30%(46/630)，2组差异有统计学意义(P＜0.05)。干预组手术室医生、手术室护士和消毒供应中心护士对外来医疗器械管理工作的满意率均明显高于对照组，差异有统计学意义(P＜0.01)。结论基于赋码的消毒供应中心外来医疗器械链式管理模式有利于减少管理差错，保障医疗安全，并有效提高医护人员的工作满意度，是值得临床参考借鉴的科学管理模式。
- 外来医疗器械 /
- 链式管理 /
- 安全管理 /
- 消毒供应中心
Abstract: Objective The chain management scheme based on coding was implemented in the Central Sterile Supply Department for external medical devices, and its influence on the unqualified rate of quality control and job satisfaction rate of medical staff was discussed. Methods A total of 90 external medical instrument sets from the Central Sterile Supply Department of the Second Affiliated Hospital of Wenzhou Medical University from January 17 to February 6, 2022 were randomly selected as the control group, and 90 external medical instrument sets from June 13, 2022 to July 3, 2022 were randomly selected as the intervention group. The control group adopted the traditional external medical device management mode, and the intervention group implemented the external medical device chain management scheme based on coding on the basis of the control group in our hospital on March 1, 2022. The unqualified rate of external medical device management and the satisfaction rate of medical staff were compared between the two groups. Results The unqualified rate was 24.76% (156/630)in the intervention group and 7.30% (46/630) in the intervention group, the difference between the two groups was statistically significant (P < 0.05).The satisfaction rate of the operating room doctors, nurses and nurses in the disinfection supply center in the intervention group was significantly higher than that in the control group, and the difference was statistically significant (P < 0.01). Conclusion The external medical device chain management model based on coding is beneficial to reduce management errors, to ensure medical safety and improve the job satisfaction of medical staff. It is a scientific management model worthy of clinical reference.
- External medical devices /
- Chain management /
- Safety management /
- Central Sterile Supply Department

HTML全文

图 1 外来医疗器械链式管理环节链与人员链

Figure 1. External medical device chain management link chain and personnel chain

下载: 全尺寸图片幻灯片

表 1 2组外来医疗器械链式管理环节质量控制检测不合格率比较[n(%)]

Table 1. Comparison of unqualified rate of quality control test in chain management of foreign medical devices between two groups [n(%)]

项目	对照组(n=630)	干预组(n=630)	χ²值	P值
器械验收	12(1.90)	4(0.63)	4.051	0.044
配送接收	42(6.67)	17(2.70)	11.114	0.001
清洗消毒	10(1.59)	1(0.16)	7.428	0.006
装配包装	49(7.78)	12(1.90)	23.584	＜0.001
灭菌	9(1.43)	1(0.16)	6.451	0.011
手术室使用	9(1.43)	1(0.16)	6.451	0.011
回收处理	25(3.97)	10(1.59)	6.612	0.010
合计	156(24.76)	46(7.30)	71.338	＜0.001

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表 2 2组医护人员对外来医疗器械管理工作满意度比较(x±s，分)

Table 2. Comparison of the satisfaction of medical workers in the management of foreign medical devices between the two groups(x±s, points)

组别	人数	管理流程	图谱装配	消毒灭菌	扫码使用	回收处理	总得分
对照组	60	11.13±1.27	10.36±1.23	17.34±2.01	11.54±1.34	13.41±2.24	61.37±1.76
干预组	60	18.45±1.35	18.57±1.17	18.76±1.12	18.55±1.27	18.64±1.11	90.23±1.35
t值		30.591	37.462	4.780	29.411	16.205	100.78
P值		＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

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参考文献(16)

[1]	巩玉秀, 冯秀兰, 付强, 等. 医院消毒供应中心第1部分: 管理规范WS310.1-2016[J]. 中国感染控制杂志, 2017, 16(9): 887-892. https://www.cnki.com.cn/Article/CJFDTOTAL-GRKZ201711025.htm GONG Y X, FENG X L, FU Q, et al. Central sterile supply department (CSSD)—Part 1 : Management standard[J]. Chinese Journal of Infection Control, 2017, 16(9): 887-892. https://www.cnki.com.cn/Article/CJFDTOTAL-GRKZ201711025.htm
[2]	徐琴, 钱维明, 赵体玉, 等. 1166家公立医院手术外来医疗器械管理现状调查[J]. 中国护理管理, 2022, 22(10): 1477-1481. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL202210009.htm XU Q, QIAN W M, ZHAO T Y, et al. Investigation on the current management situation of foreign surgical instruments in 1166 public hospitals in China[J]. Chinese Nursing Management, 2022, 22(10): 1477-1481. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL202210009.htm
[3]	崔倩, 李漫春, 詹朦, 等. 2008—2021年医院CSSD外来医疗器械及植入物管理现状Meta分析[J]. 中国感染控制杂志, 2022, 21(5): 430-438. https://www.cnki.com.cn/Article/CJFDTOTAL-GRKZ202205004.htm CUI Q, LI M C, ZHAN M, et al. Current management status of loaner medical instruments and implants in hospital central sterile supply department from 2008 to 2021: a Meta-analysis[J]. Chinese Journal of Infection Control, 2022, 21(5): 430-438. https://www.cnki.com.cn/Article/CJFDTOTAL-GRKZ202205004.htm
[4]	王非凡, 屈红, 刘晓轶. 医联体合作模式下链式管理在延续护理中的实践[J]. 护理学杂志, 2021, 36(19): 1-4. doi: 10.3870/j.issn.1001-4152.2021.19.001 WANG F F, QU H, LIU X Y. Practice of chain management assisted continuous nursing care the model of medical collaboration alliance[J]. Journal of Nursing Science, 2021, 36(19): 1-4. doi: 10.3870/j.issn.1001-4152.2021.19.001
[5]	陈晓珍, 黄彬, 周勇清, 等. 急救链式管理在胸心外科护理管理中的应用[J]. 中医药管理杂志, 2020, 28(20): 65-66. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYG202020033.htm CHEN X Z, HUANG B, ZHOU Y Q, et al. Application of emergency chain management in nursing management of thoracic and cardiac surgery[J]. Journal of Chinese Medicine Administration, 2020, 28(20): 65-66. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYG202020033.htm
[6]	方继红, 武凤芹, 李镇宇, 等. 儿童创伤性疼痛链式管理方案的制订及应用[J]. 中华护理杂志, 2020, 55(8): 1154-1158. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHHL202008007.htm FANG J H, WU F Q, LI Z Y, et al. Formulation and clinical practice of a chain management scheme of traumatic pain in children[J]. Chinese Journal of Nursing, 2020, 55(8): 1154-1158. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHHL202008007.htm
[7]	吕忠美, 杨小华, 席巍, 等. 链式管理在农村空巢老年糖尿病患者胰岛素注射中的应用研究[J]. 中华护理杂志, 2022, 57(23): 2904-2911. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHHL202223012.htm LYU Z M, YANG X H, XI W, et al. Effect of chain management on insulin injection management ability of rural empty nest elderly diabetic patients[J]. Chinese Journal of Nursing, 2022, 57(23): 2904-2911. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHHL202223012.htm
[8]	王煜, 韩丁, 边寒雪, 等. 链式管理预防小儿神经外科手术压力性损伤的效果[J]. 中华全科医学, 2021, 19(11): 1964-1968. doi: 10.16766/j.cnki.issn.1674-4152.002212 WANG Y, HAN D, BIAN H X, et al. Application of chain management to prevent pressure injury in paediatric neurosurgery[J]. Chinese Journal of General Practice, 2021, 19(11): 1964-1968. doi: 10.16766/j.cnki.issn.1674-4152.002212
[9]	顾洁, 张茵英. 基于链式管理模式的多学科联合健康教育对门诊高血压患者服药依从性的影响[J]. 解放军护理杂志, 2019, 36(5): 54-57. https://www.cnki.com.cn/Article/CJFDTOTAL-JFHL201905018.htm GU J, ZHANG Y Y. Effect of Multi-disciplinary Combined Health Education on the Drug Compliance of Outpatient with Hypertension Based on Chain Management Mode[J]. Nursing Journal of Chinese People ' s Liberation Army, 2019, 36(5): 54-57. https://www.cnki.com.cn/Article/CJFDTOTAL-JFHL201905018.htm
[10]	李妍, 宋青青, 黄娟, 等. 赋权视角下链式管理模式在川崎病患儿居家护理中的应用[J]. 齐鲁护理杂志, 2023, 29(19): 5-8. https://www.cnki.com.cn/Article/CJFDTOTAL-QLHL202319002.htm LI Y, SONG Q Q, HUANG J, et al. Application of Chain Management Model under Empowerment Perspective in the Home Care of Children with Kawasaki Disease[J]. Journal of Qilu Nursing, 2023, 29(19): 5-8. https://www.cnki.com.cn/Article/CJFDTOTAL-QLHL202319002.htm
[11]	张青, 钱黎明, 王旭, 等. 外来医疗器械清洗消毒及灭菌技术操作指南[M]. 北京: 北京科学技术出版社, 2018. ZHANG Q, QIAN L M, WANG X, et al. Technical Operation Guide for Cleaning, Disinfection and Sterilization of foreign Medical Devices[M]. Beijing: Beijing Science and Technology Press, 2018.
[12]	陈美, 夏琴, 李雨静, 等. 外来医疗器械与植入物链式管理的构建及应用[J]. 护士进修杂志, 2021, 36(8): 717-720. https://www.cnki.com.cn/Article/CJFDTOTAL-FSJX202108011.htm CHEN M, XIA Q, LI Y J, et al. Construction and application of chain management of external medical devices and implants[J]. Journal of Nurses Training, 2021, 36(8): 717-720. https://www.cnki.com.cn/Article/CJFDTOTAL-FSJX202108011.htm
[13]	魏娟青, 蒋美娜. 强化质量监控及持续改进在消毒供应中心感染防控中的作用探讨[J]. 中华全科医学, 2020, 18(12): 2125-2127. doi: 10.16766/j.cnki.issn.1674-4152.001704 WEI J Q, JIANG M N. Discussion on the role of strengthening quality control and continuous improvement in infection prevention and control of disinfection supply center[J]. Chinese Journal of General Practice, 2020, 18(12): 2125-2127. doi: 10.16766/j.cnki.issn.1674-4152.001704
[14]	张旭, 喻晓芬, 沈飞燕, 等. 基于环节色块的手术室标本链式管理方案的构建及应用[J]. 中国护理管理, 2022, 22(9): 1315-1319. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL202209009.htm ZHANG X, YU X F, SHEN F Y, et al. Construction and application on the surgical specimen chain management scheme based on the link color block in the operating room[J]. Chinese Nursing Management, 2022, 22(9): 1315-1319. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL202209009.htm
[15]	王亚娟, 褚叶远, 顾敏霞, 等. 标准引领下外来医疗器械及植入物管理逐步完善的实践与思考[J]. 中国护理管理, 2023, 23(8): 1134-1137. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL202308004.htm WANG Y J, CHU Y Y, GU M X, et al. Practice and thinking of the gradual improvement of loaned instruments and implants under the leading of regulations[J]. Chinese Nursing Management, 2023, 23(8): 1134-1137. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL202308004.htm
[16]	刘东玲, 秦月兰, 余正香, 等. 外来医疗器械清洗消毒灭菌管理研究进展[J]. 中国医学装备, 2022, 19(8): 189-193. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZB202208041.htm LIU D L, QIN Y L, YU Z X, et al. Research progress on the management of cleaning, disinfection and sterilization of loaner medical instrumentation[J]. China Medical Equipment, 2022, 19(8): 189-193. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZB202208041.htm